| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $65.78 | $116.45 | $197.61 | |
Medcost
| Facility | $142.63 | $142.63 | $142.63 |
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $65.78 | $116.45 | $197.61 | |
Medcost
| Facility | $142.63 | $142.63 | $142.63 |